Air pollution and emergency admissions for cardiorespiratory diseases in Lisbon (Portugal)

Daily records of hospital admissions due to cardiorespiratory diseases and levels of PM10, SO2, CO, NO, NO2, and O3 were collected from 1999-2004 to evaluate the relationship between air pollution and morbidity in Lisbon. Generalised additive Poisson regression models were adopted, controlling for temperature, humidity, and both short and long-term seasonality. Significant positive associations, lagged by 1 or 2 days, were found between markers of traffic-related pollution (CO and NO2) and cardiocirculatory diseases in all age groups. Increased childhood emergency admissions for respiratory illness were significantly correlated with the 1-day lagged SO2 levels coming from industrial activities.

Climate risk in maize crop in the northeastern of Brazil based on climate change scenarios

This study evaluates the impacts of climate change on the agricultural zoning of climatic risk in maize crop cultivated in the Northeastern of Brazil, based on the Intergovernmental Panel on Climate Change (IPCC) reports. The water balance model, combined with geospatial technologies, was used to identify areas of the study region where the crops could suffer yield restrictions due to climate change. The data used in the study were the time series of rainfall with at least 30 years of daily data, crop coefficients, potential evapotranspiration and duration of the crop cycle. The scenarios of the increasing of air temperature used in the simulations were of 1.5ºC, 3ºC and 5ºC. The sowing date of maize crop from January to March appears to be less affected by warming scenarios than the sowing in November and December or April and May.

Effect of air pollution on pediatric respiratory emergency room visits and hospital admissions

In order to assess the effect of air pollution on pediatric respiratory morbidity, we carried out a time series study using daily levels of PM10, SO2, NO2, ozone, and CO and daily numbers of pediatric respiratory emergency room visits and hospital admissions at the Children's Institute of the University of São Paulo Medical School, from August 1996 to August 1997. In this period there were 43,635 hospital emergency room visits, 4534 of which were due to lower respiratory tract disease. The total number of hospital admissions was 6785, 1021 of which were due to lower respiratory tract infectious and/or obstructive diseases. The three health end-points under investigation were the daily number of emergency room visits due to lower respiratory tract diseases, hospital admissions due to pneumonia, and hospital admissions due to asthma or bronchiolitis. Generalized additive Poisson regression models were fitted, controlling for smooth functions of time, temperature and humidity, and an indicator of weekdays. NO2 was positively associated with all outcomes. Interquartile range increases (65.04 µg/m³) in NO2 moving averages were associated with an 18.4% increase (95% confidence interval, 95% CI = 12.5-24.3) in emergency room visits due to lower respiratory tract diseases (4-day moving average), a 17.6% increase (95% CI = 3.3-32.7) in hospital admissions due to pneumonia or bronchopneumonia (3-day moving average), and a 31.4% increase (95% CI = 7.2-55.7) in hospital admissions due to asthma or bronchiolitis (2-day moving average). The study showed that air pollution considerably affects children's respiratory morbidity, deserving attention from the health authorities.

Effect of air pollution on diabetes and cardiovascular diseases in São Paulo, Brazil

Type 2 diabetes increases the risk of cardiovascular mortality and these patients, even without previous myocardial infarction, run the risk of fatal coronary heart disease similar to non-diabetic patients surviving myocardial infarction. There is evidence showing that particulate matter air pollution is associated with increases in cardiopulmonary morbidity and mortality. The present study was carried out to evaluate the effect of diabetes mellitus on the association of air pollution with cardiovascular emergency room visits in a tertiary referral hospital in the city of São Paulo. Using a time-series approach, and adopting generalized linear Poisson regression models, we assessed the effect of daily variations in PM10, CO, NO2, SO2, and O3 on the daily number of emergency room visits for cardiovascular diseases in diabetic and non-diabetic patients from 2001 to 2003. A semi-parametric smoother (natural spline) was adopted to control long-term trends, linear term seasonal usage and weather variables. In this period, 45,000 cardiovascular emergency room visits were registered. The observed increase in interquartile range within the 2-day moving average of 8.0 µg/m³ SO2 was associated with 7.0% (95%CI: 4.0-11.0) and 20.0% (95%CI: 5.0-44.0) increases in cardiovascular disease emergency room visits by non-diabetic and diabetic groups, respectively. These data indicate that air pollution causes an increase of cardiovascular emergency room visits, and that diabetic patients are extremely susceptible to the adverse effects of air pollution on their health conditions.

Air pollution and cardiovascular hospital admissions in a medium-sized city in São Paulo State, Brazil

The objective of the present study was to estimate the contribution of environmental pollutants to hospital admissions for cardiovascular disease. A time series ecological study was conducted on subjects aged over 60 years and living in São José dos Campos, Brazil, with a population near 700,000 inhabitants. Hospital admission data of public health patients (SUS) were obtained from DATASUS for the period between January 1, 2004 and December 31, 2006, according to the ICD-10 diagnoses I20 to I22 and I24. Particulate matter with less than 10 µm in aerodynamic diameter, sulfur dioxide and ozone were the pollutants examined, and the control variables were mean temperature and relative humidity. Data on pollutants were obtained from the São Paulo State Sanitary Agency. The generalized linear model Poisson regression with lags of up to 5 days was used. There were 1303 hospital admissions during the period. Exposure to particulate matter was significantly associated with hospitalization for cardiovascular disease 3 days after exposure (RR = 1.006; 95%CI = 1.000 to 1.010) and an increase of 16 µg/m³ was associated with a 10% increase in risk of hospitalization; other pollutants were not associated with hospitalization. Thus, it was possible to identify the role of exposure to particulate matter as an environmental pollutant in hospitalization for cardiovascular disease in a medium-sized city inSoutheastern Brazil.

The contribution of the European Union to global climate change governance: explaining the conditions for EU actorness

Como organização regional, o papel da União Europeia na governança global do clima enfrenta obstáculos que não se aplicam a nenhuma outra parte da Convenção-Quadro das Nações Unidas sobre a Mudança do Clima (CQNUMC) e do Protocolo de Quioto. Avaliando essa singularidade, este artigo fornece uma analise teórica e empírica de como os elementos de actorness (reconhecimento, capacidade, oportunidade e coesão) definem a participação da UE no regime internacional de mudanças climáticas.

The Brazilian position on forests and climate change from 1997 to 2012: from veto to proposition

This article describes the Brazilian position on forests and climate change from 1997 to 2012. It argues that it has evolved from a veto, which excluded from the climate change regime emissions from the conversion of native forests, to a proposition, as Brazil offered its approach to the international community. It explains the change with domestic developments: governance over deforestation, the emergence of new and relevant actors, and presidential diplomacy.

Governance of global climate change in the Brazilian Amazon: the case of Amazonian municipalities of Brazil

With regards to the debate about governance of climate change, it should be assumed that the Amazon region plays an important role, as this large area is highly vulnerable to its effects. In this sense, this article aims to discuss how some Amazonian municipalities of Brazil have been taking part in the complexes and multilayered processes of climate governance.

MICROFINANCE AND CLIMATE CHANGE IMPACTS: THE CASE OF AGROAMIGO IN BRAZIL

ABSTRACTThis paper reports an empirical case study on the interface between microfinance and climate change actions. Climate change, which until recently seemed a luxury for the microfinance sector, now appears to be crucial for its future. For their low adaptive capacity, the millions of microfinance clients worldwide happen to be the most vulnerable to a changing climate. However, such an arena is still blurred from an academic viewpoint, and inexistent among Brazilian academia. Therefore, by investigating Brazil’s largest rural MFI, Agroamigo, we aim at providing an empirical contribution to green microfinance. The main conclusion is that, albeit Agroamigo offers important links to climate change initiatives, it will need to take better account of specific vulnerabilities and risks to protect its portfolio and clients better from climate change impacts.

Principal components and generalized linear modeling in the correlation between hospital admissions and air pollution

OBJECTIVE To analyze the association between concentrations of air pollutants and admissions for respiratory causes in children. METHODS Ecological time series study. Daily figures for hospital admissions of children aged < 6, and daily concentrations of air pollutants (PM10, SO2, NO2, O3 and CO) were analyzed in the Região da Grande Vitória, ES, Southeastern Brazil, from January 2005 to December 2010. For statistical analysis, two techniques were combined: Poisson regression with generalized additive models and principal model component analysis. Those analysis techniques complemented each other and provided more significant estimates in the estimation of relative risk. The models were adjusted for temporal trend, seasonality, day of the week, meteorological factors and autocorrelation. In the final adjustment of the model, it was necessary to include models of the Autoregressive Moving Average Models (p, q) type in the residuals in order to eliminate the autocorrelation structures present in the components. RESULTS For every 10:49 μg/m3 increase (interquartile range) in levels of the pollutant PM10 there was a 3.0% increase in the relative risk estimated using the generalized additive model analysis of main components-seasonal autoregressive – while in the usual generalized additive model, the estimate was 2.0%. CONCLUSIONS Compared to the usual generalized additive model, in general, the proposed aspect of generalized additive model − principal component analysis, showed better results in estimating relative risk and quality of fit.

Methods and challenges for the health impact assessment of vaccination programs in Latin America

ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. RESULTS We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. CONCLUSIONS Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

Environmental sanitation conditions and health impact: a case-control study

This epidemiological investigation examines the impact of several environmental sanitation conditions and hygiene practices on diarrhea occurrence among children under five years of age living in an urban area. The case-control design was employed; 997 cases and 999 controls were included in the investigation. Cases were defined as children with diarrhea and controls were randomly selected among children under five years of age. After logistic regression adjustment, the following variables were found to be significantly associated with diarrhea: washing and purifying fruit and vegetables; presence of wastewater in the street; refuse storage, collection and disposal; domestic water reservoir conditions; feces disposal from swaddles; presence of vectors in the house and flooding in the lot. The estimates of the relative risks reached values up to 2.87. The present study revealed the feasibility of developing and implementing an adequate model to establish intervention priorities in the field of environmental sanitation.